Abnormalities of peripheral nerve in patients with human immunodeficiency virus infection

• Published in: Annals of neurology Vol. 24; no. 6; p. 713
• Main Authors: Mah, V, Vartavarian, L M, Akers, M A, Vinters, H V
• Format: Journal Article
• Language: English
• Published: United States 01-12-1988
• Subjects: Acquired Immunodeficiency Syndrome - complications; Adult; AIDS-Related Complex - complications; AIDS-Related Complex - pathology; Female; Humans; Male; Microscopy, Electron; Middle Aged; Nerve Fibers, Myelinated - pathology; Peripheral Nervous System Diseases - etiology; Peripheral Nervous System Diseases - pathology; Spinal Nerves - pathology; Sural Nerve - pathology; Wallerian Degeneration
• ISSN: 0364-5134
• DOI: 10.1002/ana.410240604

The purpose of this study was to assess systematically morphology of peripheral nerves from patients with human immunodeficiency virus infection (acquired immunodeficiency syndrome [AIDS] and AIDS-related complex) examined at autopsy. Sural nerve specimens were taken from 25 patients (mean age 44 years) and evaluated by routine procedures used in our laboratory. In 13 cases no detectable abnormality was seen. Twelve patients (48%) showed loss of myelinated fibers with disproportionately greater loss of large myelinated fibers. Three of these patients showed severe myelinated fiber loss; 2 had no documented symptoms and no other known predisposing factors for a peripheral neuropathy. Changes suggestive of wallerian degeneration were occasionally seen, as were epineurial and endoneurial inflammatory infiltrates. Segmental demyelination was not identified in any nerve examined. Electron microscopy revealed thickened basement membranes around small blood vessels, Schwann cells, and fibroblasts. Peripheral nerve abnormalities in patients with AIDS or ARC are frequent and their pathogenesis remains unclear.